The Effectiveness of Fluoroscopy-Guided Manual Lymph Drainage as Part of Decongestive Lymphatic Therapy on the Superficial Lymphatic Architecture in Patients with Breast Cancer-Related Lymphoedema: A Randomised Controlled Trial
The objective of this trial was to investigate the effectiveness of fluoroscopy-guided manual lymph drainage (MLD), as part of decongestive lymphatic therapy (DLT), on the superficial lymphatic architecture in patients with chronic mild to moderate breast cancer-related lymphoedema (BCRL). This tria...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/5/1545 |
| _version_ | 1797615648523681792 |
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| author | Nele Devoogdt Sarah Thomis An De Groef An-Kathleen Heroes Ines Nevelsteen Nick Gebruers Wiebren A. A. Tjalma Jean-Paul Belgrado Chris Monten Marianne Hanssens Tessa De Vrieze |
| author_facet | Nele Devoogdt Sarah Thomis An De Groef An-Kathleen Heroes Ines Nevelsteen Nick Gebruers Wiebren A. A. Tjalma Jean-Paul Belgrado Chris Monten Marianne Hanssens Tessa De Vrieze |
| author_sort | Nele Devoogdt |
| collection | DOAJ |
| description | The objective of this trial was to investigate the effectiveness of fluoroscopy-guided manual lymph drainage (MLD), as part of decongestive lymphatic therapy (DLT), on the superficial lymphatic architecture in patients with chronic mild to moderate breast cancer-related lymphoedema (BCRL). This trial was a multicentre, double-blind, randomised controlled trial involving 194 participants with BCRL. Participants were randomised into (1) DLT with fluoroscopy-guided MLD (intervention group), (2) DLT with traditional MLD (control group), or (3) DLT with placebo MLD (placebo group). Superficial lymphatic architecture was evaluated as a secondary outcome, visualised by ICG lymphofluoroscopy at the baseline (B0), post-intensive (P), and post-maintenance phases (P6). Variables were (1) number of efferent superficial lymphatic vessels leaving the dermal backflow region, (2) total dermal backflow score, and (3) number of superficial lymph nodes. The traditional MLD group showed a significant decrease in the number of efferent superficial lymphatic vessels at P (<i>p</i> = 0.026), and of the total dermal backflow score at P6 (<i>p</i> = 0.042). The fluoroscopy-guided MLD and placebo group showed significant decreases in the total dermal backflow score at P (<i>p</i> < 0.001 and <i>p</i> = 0.044, respectively) and at P6 (<i>p</i> < 0.001 and <i>p</i> = 0.007, respectively); the placebo MLD group showed a significant decrease in the total number of lymph nodes at P (<i>p</i> = 0.008). However, there were no significant between-group differences for the changes in these variables. In conclusion, based on lymphatic architecture outcomes, the added value of MLD, in addition to the other parts of DLT, could not be demonstrated in patients with chronic mild to moderate BCRL. |
| first_indexed | 2024-03-11T07:28:35Z |
| format | Article |
| id | doaj.art-5696595d2eca41b081755ffac6dbe7e4 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T07:28:35Z |
| publishDate | 2023-02-01 |
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| record_format | Article |
| series | Cancers |
| spelling | doaj.art-5696595d2eca41b081755ffac6dbe7e42023-11-17T07:25:32ZengMDPI AGCancers2072-66942023-02-01155154510.3390/cancers15051545The Effectiveness of Fluoroscopy-Guided Manual Lymph Drainage as Part of Decongestive Lymphatic Therapy on the Superficial Lymphatic Architecture in Patients with Breast Cancer-Related Lymphoedema: A Randomised Controlled TrialNele Devoogdt0Sarah Thomis1An De Groef2An-Kathleen Heroes3Ines Nevelsteen4Nick Gebruers5Wiebren A. A. Tjalma6Jean-Paul Belgrado7Chris Monten8Marianne Hanssens9Tessa De Vrieze10Department of Rehabilitation Sciences, KU Leuven—University of Leuven, 3000 Leuven, BelgiumDepartment of Vascular Surgery, Centre for Lymphedema, UZ Leuven—University Hospitals Leuven, 3000 Leuven, BelgiumDepartment of Rehabilitation Sciences, KU Leuven—University of Leuven, 3000 Leuven, BelgiumDepartment of Rehabilitation Sciences, KU Leuven—University of Leuven, 3000 Leuven, BelgiumMultidisciplinary Breast Centre, UZ Leuven—University Hospitals Leuven, 3000 Leuven, BelgiumDepartment of Rehabilitation Sciences and Physiotherapy, University of Antwerp, MOVANT, 2610 Antwerp, BelgiumMultidisciplinary Breast Clinic and Multidisciplinary Oedema Clinic, Antwerp University Hospital, 2650 Antwerp, BelgiumLymphology Research Unit, Université libre de Bruxelles, 1070 Brussels, BelgiumDepartment of Radiotherapy, Ghent University Hospital, 9000 Ghent, BelgiumDepartment of Oncology, Centre for Oncology, General Hospital Groeninge, 8500 Kortrijk, BelgiumDepartment of Rehabilitation Sciences, KU Leuven—University of Leuven, 3000 Leuven, BelgiumThe objective of this trial was to investigate the effectiveness of fluoroscopy-guided manual lymph drainage (MLD), as part of decongestive lymphatic therapy (DLT), on the superficial lymphatic architecture in patients with chronic mild to moderate breast cancer-related lymphoedema (BCRL). This trial was a multicentre, double-blind, randomised controlled trial involving 194 participants with BCRL. Participants were randomised into (1) DLT with fluoroscopy-guided MLD (intervention group), (2) DLT with traditional MLD (control group), or (3) DLT with placebo MLD (placebo group). Superficial lymphatic architecture was evaluated as a secondary outcome, visualised by ICG lymphofluoroscopy at the baseline (B0), post-intensive (P), and post-maintenance phases (P6). Variables were (1) number of efferent superficial lymphatic vessels leaving the dermal backflow region, (2) total dermal backflow score, and (3) number of superficial lymph nodes. The traditional MLD group showed a significant decrease in the number of efferent superficial lymphatic vessels at P (<i>p</i> = 0.026), and of the total dermal backflow score at P6 (<i>p</i> = 0.042). The fluoroscopy-guided MLD and placebo group showed significant decreases in the total dermal backflow score at P (<i>p</i> < 0.001 and <i>p</i> = 0.044, respectively) and at P6 (<i>p</i> < 0.001 and <i>p</i> = 0.007, respectively); the placebo MLD group showed a significant decrease in the total number of lymph nodes at P (<i>p</i> = 0.008). However, there were no significant between-group differences for the changes in these variables. In conclusion, based on lymphatic architecture outcomes, the added value of MLD, in addition to the other parts of DLT, could not be demonstrated in patients with chronic mild to moderate BCRL.https://www.mdpi.com/2072-6694/15/5/1545breast neoplasmlymphoedemamanual lymph drainagelymphatic systemnear infrared fluorescence lymphatic imagingmolecular imaging |
| spellingShingle | Nele Devoogdt Sarah Thomis An De Groef An-Kathleen Heroes Ines Nevelsteen Nick Gebruers Wiebren A. A. Tjalma Jean-Paul Belgrado Chris Monten Marianne Hanssens Tessa De Vrieze The Effectiveness of Fluoroscopy-Guided Manual Lymph Drainage as Part of Decongestive Lymphatic Therapy on the Superficial Lymphatic Architecture in Patients with Breast Cancer-Related Lymphoedema: A Randomised Controlled Trial Cancers breast neoplasm lymphoedema manual lymph drainage lymphatic system near infrared fluorescence lymphatic imaging molecular imaging |
| title | The Effectiveness of Fluoroscopy-Guided Manual Lymph Drainage as Part of Decongestive Lymphatic Therapy on the Superficial Lymphatic Architecture in Patients with Breast Cancer-Related Lymphoedema: A Randomised Controlled Trial |
| title_full | The Effectiveness of Fluoroscopy-Guided Manual Lymph Drainage as Part of Decongestive Lymphatic Therapy on the Superficial Lymphatic Architecture in Patients with Breast Cancer-Related Lymphoedema: A Randomised Controlled Trial |
| title_fullStr | The Effectiveness of Fluoroscopy-Guided Manual Lymph Drainage as Part of Decongestive Lymphatic Therapy on the Superficial Lymphatic Architecture in Patients with Breast Cancer-Related Lymphoedema: A Randomised Controlled Trial |
| title_full_unstemmed | The Effectiveness of Fluoroscopy-Guided Manual Lymph Drainage as Part of Decongestive Lymphatic Therapy on the Superficial Lymphatic Architecture in Patients with Breast Cancer-Related Lymphoedema: A Randomised Controlled Trial |
| title_short | The Effectiveness of Fluoroscopy-Guided Manual Lymph Drainage as Part of Decongestive Lymphatic Therapy on the Superficial Lymphatic Architecture in Patients with Breast Cancer-Related Lymphoedema: A Randomised Controlled Trial |
| title_sort | effectiveness of fluoroscopy guided manual lymph drainage as part of decongestive lymphatic therapy on the superficial lymphatic architecture in patients with breast cancer related lymphoedema a randomised controlled trial |
| topic | breast neoplasm lymphoedema manual lymph drainage lymphatic system near infrared fluorescence lymphatic imaging molecular imaging |
| url | https://www.mdpi.com/2072-6694/15/5/1545 |
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